Tuesday, September 22, 2009

Experiencing Our Health Care System From the Inside

I am (hopefully) back after experiencing our great American health care system in depth. I had the opportunity to experience my fair city's 911 response, the local hospital's emergency room from the inside, how long it takes to get a bed when admitted from said ER (approximately 36-hours) rather than the doctor's office (approximately 4-hours) regardless of need, condition, or location in the emergency room.

I was fortunate in that my first 18 or so hours in the ER I was in the "isolation" room and thus could close the door on the screams and rants of the guests who wanted (needed?) pharmaceuticals or other services. I knew that hospitals could be noisy, but night-time in the ER was quite an education. I felt badly when I realized (on my way out of the ER) that the hallway walls were designated with "room" numbers and gurneys were lined up, each containing a patient, none of whom had a chair for a visitor, a nightstand to hold their glasses or cup of ice chips, or most important, a privacy curtain. At night, my light was turned out, but hall lights never are. Imagine. And this, with an average 36-hour wait for a bed.

Perhaps I should note that the hospital my insurance company selected is also one of the designated community medical hospitals and as such, receives all the uninsured. They (heavily) market themselves as a bariatric (weight loss) hospital ensuring that patients entering for elective (and thus, self-pay) surgery, have most of the beds. I had hoped that their wise financial choices might be reflected in my bill, but not so much.

Late the following morning after my entry into the ER, I was judged stable enough to no longer need the "isolation" room and was moved into what had been a treatment room, which I shared with one other patient who fortunately spent most of her time off being x-rayed and cat-scanned and ultra-sounded, and which also contained the bathroom, and unfortunately, was the only bathroom for the use of approximately 8 ER beds. Privacy, modesty, and confidentiality are scarce commodities in hospitals and almost non-existent within the fabric walls of the ER.

In any case, I eventually received a bed--and excellent care. My roommates changed periodically as I waited (and waited) to be well enough for surgery, and occasionally actually slept. I anticipated a quieter atmosphere on "med-surg" but there were as many screamers up there as in ER, and one night of excitement with the young man who escaped his handlers on the way from the ER to psych and decided to detour through our floor thinking we had all the good stuff. All in all, I was impressed with the quality of care I received and as far as I could see, believe that even the uninsured patients received the same quality of care--just much less as they were not invited to stay as long as I.

My roommates were an interesting mix. One was there to take advantage of the hospital's heavily marketed lapband services, coming in from out of town to have the procedure. I was a little disturbed when I overheard her talking on the phone and observed that although on disability, (and in no way obese), somehow she had managed to qualify for lapband surgery and get insurance coverage for the procedure that I had always thought was purely elective. Oh well, obviously not for me to judge. I was a little irked, however, when I returned from surgery to discover she had checked out and mistaken the contents of my nightstand for her own, but whatever. She has to look at her own face in the mirror each day, not me.

Another roommate was young, spoiled, and naive. To my amazement, she is a nurse, but did not understand the instructions "nothing by mouth" or "liquid diet only." When she discovered she might have a problem with her gallbladder causing her pain despite normal lab and other test results, she (at age 22) demanded its removal because it might, someday, cause problems and hurt, so since it was, maybe, the cause of her intense (minor to anyone else) pain, it must be removed. To me? An instance of waste in the system. A rich girl (Mom went out and bought her a MacBook Pro so she would have something to do while in bed when she got bored with her iTouch and iPhone) whose doctor admitted her because she'd had unexplainable symptoms for 4 hours, but the obvious ability to pay.

Meanwhile, patients around me were being discharged in severe pain, one roommate still on oxygen with worsening symptoms, but her insurance company had said she'd been there long enough, so home she went, alone, by taxi, oxygen tank in hand.

When I was admitted, I was told I could be there three days, or three months--very encouraging. In my case, I had to wait for surgery for medical reasons. Normally, I would go home the next day but they wanted to keep me an additional day. I had to plead to go home and was advised to stay two or three more days and was finally, grudgingly allowed to leave. I have insurance, so obviously I was a patient they wanted to keep, and I admit, in retrospect, I should have stayed. But 20% of even the best insurance (and I do not have the best, or even the second best) is a lot of money for someone who is still incomeless.

My major impetus to leave, however, was my last roommate--she of the MacBook--who insisted on watching Fox News non-stop and discussing same with her mother, also non-stop. Not being much for the TV machine myself, I did finally turn mine on in self-defense. However, being actually quite ill, I was trying to sleep whereas my neighbor was trying to obtain surgery. The nifty gadgets that serve as call buttons, TV remote, and TV speakers, had 2 volumes--on or off--so I was unable to not listen. So, despite medical advise, they finally let me out which although in retrospect probably wasn't the wisest choice, did allow me a couple of days over the holiday weekend to settle in with family at home to help and reduced my stress levels enormously by limiting my intake of Fox News propaganda.

Anyhoo, I am home and have been now for a couple of weeks. I am finally able to use my computer, briefly, and got caught up on my email and skimmed through some of the headlines and blogs to see what I've missed. It's amazing when you're sick how little energy you have to even read, much less engage with the world around you.

But, I'm back. My posts will be a little less frequent for awhile, but I do hope you continue to stop by. Come back soon.

Will Ferrell Speaks Up For Real Health Care Victims

Thanks for stopping by. Come back soon.